Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
The study aims to identify the role of Nizwa University in disseminating the concept of knowledge economy among students from the point of view of the faculty members. The researchers used the descriptive approach, as well as used a questionnaire consisting of (20) items distributed into (4) fields. It was administered to a sample of (93) Faculty members. The results of the study showed that the role of the Nizwa University in spreading the concept of knowledge economy among students from the point of view of the faculty members was of a moderate degree. The education and training field came first with the highest average, while the scientific research and innovation field came in the last level. There were no statistically significant d
... Show MoreResveratrol, (RES), a phytoalexin, is well-known for its anti-inflammatory and anti-oxidant properties. SEB, a superantigen, is known to trigger ALI and cause mortality. In the current study, we tested the effect of RES in a dual-dose model of SEB exposure that triggers ALI and causes 100% mortality in C3H/HeJ-mice. The data revealed RES attenuated SEB-induced ALI and prevented mortality. Forty eight hours post-SEB exposure, lung-infiltrating mononuclear cells were tested for microRNA expression profile to determine the epigenetic regulation by resveratrol. SEB-activated splenocytes were pre-treated with 50 μM of RES or vehicle for metabolic profile analysis by measuring oxygen consu
For a long time, the intensification of profit represented a major goal for the company management ,but this goal confirmed a series of restrictions such the constriction on short period, the time rather than on long and medium strategic goal, the relationships with customers ,the supplies, employees , This goal is replaced by another one (intensification of the company's value) ,and the fortune of the share holders itself ,for the purpose of creating value, the company must generate great outcomes to cover the operating expense and to insure the a suitable compensation to the invested capital (the market value added) is the indication used to estimate the company ability to create value –added the development
... Show MoreThe aim of the research is to measure the length between the variable the efficiency of the tax examiner with its dimensions represented by (scientific questions, practical process (experience), training and development, impartiality and independence, ethics of the profession) and the approved variable discovering the artificial adaptation of profits, and the degree of arrangement of those dimensions its importance and priority, and the research problem has been identified In a main question that is there any effect of copying the images of the image examiner in discovering the adaptation, the financial statements and reports of the companies (X, Y) and the banks (A, B) were relied on in the interpretation of the results, t
... Show MoreThe interactive websites are the interaction between the product and the user, and interactive design is based on the user interface for communication and how the interface responds to the user and how to help him to achieve his goals and enjoy the use of the interface. The interactive design is based on the design of interactive programs, i.e., programs that directly interact with the user, taking into account the different culture of the audience, the age group and many other factors. An example for the use of the user interface: Web designs, smartphone application designs and it even includes computer operating systems and electronic game interface. The interaction is the communication between the source and the receiver. The we
... Show MoreThe research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o
... Show MoreThe field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th
... Show MoreThe constructivist learning model is one of the models of constructivist theory in learning, as it generally emphasizes the active role of the learner during learning, in addition to that the intellectual and actual participation in the various activities to help students gain the skills of analyzing artistic works. The current research aims to know the effectiveness of the constructivist learning model in the acquisition of the skills of the Institute of Fine Arts for the skills of (technical work analysis). To achieve the goal, the researcher formulated the following hypothesis: There are no statistically significant differences between the average scores of the experimental group students in the skill test for analyzing artworks befor
... Show MoreThis research discusses the rehabilitation of heritage markets in the historical centers of Islamic Arab cities and their use in the field of cultural tourism as one of the most important tourist attractions and the subsequent revival of the national economy in addition to preserving the urban heritage as these markets part of the historical centers of cities. The research also discusses the preservation of the continuity of heritage markets as a product of cultural heritage value within an integrated framework to preserve the urban heritage in the historic centers of cities. The study then reviews a number of experiences of Arab and Islamic countries in the field of preserving and rehabilitating heritage markets, which qualify them to b
... Show More